Gas Goblin: Case #4

A 35-year-old driver is intubated after a high-speed MVA with rib fractures, pulmonary contusions and hypotension. He has received 3 L of 0.9% saline pre-hospital.

• ABG
• pH: 7.08 (7.35 – 7.45)
• pO₂: 65 mmHg (75 – 100)
• pCO₂: 55 mmHg (35 – 45)
• HCO₃⁻: 16 mmol/L (22 – 26)
• BE: -14 mmol/L (-3 – 3)
• SaO₂: 90 % (94 – 100)
• Na⁺: 140 mmol/L (135 – 145)
• K⁺: 4.6 mmol/L (3.5 – 5.5)
• Cl: 118 mmol/L (95 – 110)
• Ca: 1.1 mmol/L (1.12 – 1.3)
• Lactate: 8 mmol/L
• Glucose: 10 mmol/L (4 – 8)
• Urea: 6 mmol/L
• Creatinine: 90 μmol/L
• Osmolarity: 300 mOsm/L
• COHb: 1 % (0.2 – 2)
• MetHb: 1 %
• fiO2: 1

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